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Comparative effectiveness evaluation of autologous mesenchymal stem cells transplantation in terms of a single and repeated application in the multiple sclerosis treatment
Abstract
A.S. Fedulov1, A.V. Borisov1, M.M. Zafranskaya2, S.I. Krivenko3, L.N. Marchenko1, T.V. Kachan1, Yu.V. Moskovskikh1, D.B. Nizhegorodova2
1Belarusian State Medical University, Minsk
2Belarusian Medical Academy of Postgraduate Education, Minsk
3Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology
Aim: to conduct a comparative effectiveness evaluation of a single and repeated autologous mesenchymal stem cells transplantation (AMSCT) and to study AMSCT long-term results in patients with multiple sclerosis (MS).
Patients and Methods: the article presents the results of the prospective, open, longitudinal, single-center study which included 19 patients underwent single (n=12) or repeated (course) AMSCT (n=7). The control group included 12 patients with MS receiving symptomatic therapy. To following tools were used for the AMSCT effectiveness evaluation: expanded disability status scale (EDSS), brain MRI with gadolinium enhancement, optical coherent tomography (OCT). The monitoring period was 2 years.
Results: statistically significant differences in EDSS weren’t observed (T=1.7, p=0.090) among patients with MS who underwent AMSCT. An increase in the neurological deficit was observed (Т=2.67, p=0.008) in the control group receiving symptomatic treatment. The number of active demyelination foci was significantly less in the group underwent AMSCT (χ2=7.2, p=0.0073), in comparison to the control group. After repeated transplantation, there was a decrease in disability (T=2.02, p=0.04). Single AMSCT doesn’t significantly change the EDSS indicators in patients (T=0.37, p=0.710). The retinal nerve fiber layer (RNFL) thickness statistically significantly increased after repeated AMSCT (T=2.37, p=0.017). The optimal time interval for repeated AMSCT is 9–12 month considering their antiproliferative ability. Obtained results indicated AMSCT clinical efficacy and MSC reinfusion relevancy.
Conclusion: AMSCT in patients with MS allows to achieve stabilization or positive dynamics in neurological status, decrease activity in MRI and increase the RNFL thickness within 2 years after transplantation. Repeated AMSCT is more effective than a single one. MSC reinfusion should be carried out in 9–12 months after their first injection.
Abstract
A.S. Fedulov1, A.V. Borisov1, M.M. Zafranskaya2, S.I. Krivenko3, L.N. Marchenko1, T.V. Kachan1, Yu.V. Moskovskikh1, D.B. Nizhegorodova2
1Belarusian State Medical University, Minsk
2Belarusian Medical Academy of Postgraduate Education, Minsk
3Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology
Aim: to conduct a comparative effectiveness evaluation of a single and repeated autologous mesenchymal stem cells transplantation (AMSCT) and to study AMSCT long-term results in patients with multiple sclerosis (MS).
Patients and Methods: the article presents the results of the prospective, open, longitudinal, single-center study which included 19 patients underwent single (n=12) or repeated (course) AMSCT (n=7). The control group included 12 patients with MS receiving symptomatic therapy. To following tools were used for the AMSCT effectiveness evaluation: expanded disability status scale (EDSS), brain MRI with gadolinium enhancement, optical coherent tomography (OCT). The monitoring period was 2 years.
Results: statistically significant differences in EDSS weren’t observed (T=1.7, p=0.090) among patients with MS who underwent AMSCT. An increase in the neurological deficit was observed (Т=2.67, p=0.008) in the control group receiving symptomatic treatment. The number of active demyelination foci was significantly less in the group underwent AMSCT (χ2=7.2, p=0.0073), in comparison to the control group. After repeated transplantation, there was a decrease in disability (T=2.02, p=0.04). Single AMSCT doesn’t significantly change the EDSS indicators in patients (T=0.37, p=0.710). The retinal nerve fiber layer (RNFL) thickness statistically significantly increased after repeated AMSCT (T=2.37, p=0.017). The optimal time interval for repeated AMSCT is 9–12 month considering their antiproliferative ability. Obtained results indicated AMSCT clinical efficacy and MSC reinfusion relevancy.
Conclusion: AMSCT in patients with MS allows to achieve stabilization or positive dynamics in neurological status, decrease activity in MRI and increase the RNFL thickness within 2 years after transplantation. Repeated AMSCT is more effective than a single one. MSC reinfusion should be carried out in 9–12 months after their first injection.